Factors Effecting Remission and Survival in Adult Acute Nonlymphocytic Leukemia (Anll)

Wiernik, Peter H.; Serpick, Arthur A.

doi:10.1097/00005792-197011000-00004

Cited by 87 publications

(26 citation statements)

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“…Boggs et al (14) found significantly enlarged nodes in 47% of patients with ANLL compared to 76% with ALL. Wiernik and Serpick (24) found "adenopathy" in 26%, and Freireich et al (26) reported enlarged nodes in 24% of patients with ANLL, and Roath et al (15) in 46% of patients with AML, 61% with ALL and 68% with AMoL. The 64% with palpably enlarged nodes in this series is identical to the frequency reported by George et al (10) for ALL and ANLL in chldren.…”

Section: Racesupporting

confidence: 81%

“…As in this series of children, an inverse relationship of initial leukocyte count and survival has been reported in adults with ANLL (14,15,24,(67)(68)(69), but the observation has not been universal (26) and the differences not always significant (24,70). Although it is possible that the prognostic significance of the leukocyte count may disappear with more aggressive therapy (24), this has not been true for childhood ALL.…”

Section: Prognostic Factorsmentioning

confidence: 55%

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Acute nonlymphocytic leukemia in 171 children

Choi

Simone

1976

Med. Pediatr. Oncol.

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The initial features, response to therapy, complications, cause of death, and prognostic factors of 171 consecutive children with ANLL are described and compated to historical data for adults with ANLL and for children with ALL. Major differences between children and adults with ANLL include a higher frequency of CNS leukemia and a lower frequency of early deaths in the children. The most important differences between children with ANLL and ALL are the absence of a peak age of incidence in ANLL and the far better response to therapy in ALL. Among features present at 100,000/mm3 or above, and no palpable hepatomegaly had significantly longer survivals, while patients with platelet counts below 10,000/mm3 had significantly shorter survivals. The frequency and duration of remission were significantly better with three protocols used since 1968 than previously. However, even with these protocols, the results were far from satisfactory, with a complete remission frequency of 66%, a median duration of hematological remission of 6 months, and a median duration of survival of 10 months. The striking contrast of these results in childhood ANLL with current results in childhood ALL underscores the need for novel, imaginative therapeutic approaches for ANLL.

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Section: Racesupporting

confidence: 81%

Section: Prognostic Factorsmentioning

confidence: 55%

Acute nonlymphocytic leukemia in 171 children

Choi

Simone

1976

Med. Pediatr. Oncol.

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“…We found that second remissions were the rule (6/7 patients), while third and subsequent remissions commonly occurred (Freeman et al, 1973), in contrast to the general experience that relativelv few patients achieved second remission in adult AML (Wiernik and Serpick, 1970;Bailey et al, 1971;Crowther et al, 1973;Powles, 1973;Powles et al, 1973Powles et al, , 1977. There are few reports of third remissions (Whittaker and Slater, 1977 examination was repeated within 2 weeks.…”

contrasting

confidence: 54%

Active immunotherapy in acute myelogenous leukaemia and the induction of second and subsequent remissions

Harris¹,

Zuhrie²,

Freeman³

et al. 1978

Br J Cancer

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Summary.-One hundred and ninety-one adults with acute myelogenous leukaemia were treated with combination chemotherapy consisting of daunorubicin and cytosine arabinoside (Barts III). Sixty-three patients achieved remission and were admitted to one of 3 trials of active immunotherapy: immunotherapy alone, immunotherapy and maintenance chemotherapy or neither of these. All patients had weekly clinical and blood examination and monthly marrow examination. Reinduction chemotherapy was given as soon as relapse was diagnosed in the marrow. The most striking observation was that immunotherapy was associated with easy and repeated reinduction of remission and marked prolongation of survival after first relapse when compared with immunotherapy plus chemotherapy. The possible reasons for this and the value of immunotherapy are discussed in relation to the third trial still in progress which includes 2 maintenance arms, immunotherapy alone and surveillance only. The present communication describes our experience over a 6-year period of 3 trials of active immunotherapy in AML in which immunotherapy has been associated with relatively short first remissions but easy second and subsequent remission with long post-relapse survival and an excellent quality of life. PATIENTS AND METHODSPatients entered into 3 Manchester AML trials since 1971 and followed up to 15 March 1977, have received one of the therapeutic protocols summarized in Table I. Patients were not selected, and all who were referred to Manchester Royal Infirmary were treated.The diagnosis of AML was confirmed by blood examination and by marrow examination carried out by sternal or iliac-crest puncture. The aspirated material was fixed,

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“…It removes circulating blasts, but may also recruit marginated blasts into the intravascular space [8]. Cranial irradiation with 400-600 rads has been suggested on an emergency basis to control neurological complications due to leukostasis [9,10]. However, the paucity of data demonstrating a real benefit of cranial irradiation in children with hyperleukocytosis precludes its routine use.…”

Section: Discussionmentioning

confidence: 99%

Severe hyperleukocytosis and multifocal intracranial haemorrhage: not always a fatal outcome

et al. 2009

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Severe hyperleukocytosis caused by acute lymphoblastic leukaemia (ALL) is associated with an increased risk of early death due to the intracranial haemorrhage. We report on a boy who presented with ALL with an extremely high leukocyte count, who developed neurological deterioration due to multiple intracerebral haemorrhages. Adequate measures for managing this medical emergency include appropriate supportive measures and initiation of therapy to prevent symptoms of leukostasis. Aggressive measures as a decompressive craniectomy should be considered to improve the poor outcome observed in this subset of patients.

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Factors Effecting Remission and Survival in Adult Acute Nonlymphocytic Leukemia (Anll)

Cited by 87 publications

References 0 publications

Acute nonlymphocytic leukemia in 171 children

Acute nonlymphocytic leukemia in 171 children

Active immunotherapy in acute myelogenous leukaemia and the induction of second and subsequent remissions

Severe hyperleukocytosis and multifocal intracranial haemorrhage: not always a fatal outcome

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